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Supravalvar aortic stenosis(SVAS)

MedGen UID:
2001
Concept ID:
C0003499
Disease or Syndrome
Synonyms: Supravalvar aortic stenosis, Eisenberg type; Supravalvular Aortic Stenosis; SVAS
SNOMED CT: Supravalvar aortic stenosis (268185002); SVAS - Supravalvar aortic stenosis (268185002)
Modes of inheritance:
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Gene (location): ELN (7q11.23)
 
HPO: HP:0004381
Monarch Initiative: MONDO:0008504
OMIM®: 185500
Orphanet: ORPHA3193

Definition

Supravalvular aortic stenosis (SVAS) is a heart defect that develops before birth. This defect is a narrowing (stenosis) of the large blood vessel that carries blood from the heart to the rest of the body (the aorta). The condition is described as supravalvular because the section of the aorta that is narrowed is located just above the valve that connects the aorta with the heart (the aortic valve). Some people with SVAS also have defects in other blood vessels, most commonly stenosis of the artery from the heart to the lungs (the pulmonary artery). An abnormal heart sound during a heartbeat (heart murmur) can often be heard during a chest exam. If SVAS is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and ultimately heart failure.

The severity of SVAS varies considerably, even among family members. Some affected individuals die in infancy, while others never experience symptoms of the disorder. [from MedlinePlus Genetics]

Clinical features

From HPO
Supravalvar aortic stenosis
MedGen UID:
2001
Concept ID:
C0003499
Disease or Syndrome
Supravalvular aortic stenosis (SVAS) is a heart defect that develops before birth. This defect is a narrowing (stenosis) of the large blood vessel that carries blood from the heart to the rest of the body (the aorta). The condition is described as supravalvular because the section of the aorta that is narrowed is located just above the valve that connects the aorta with the heart (the aortic valve). Some people with SVAS also have defects in other blood vessels, most commonly stenosis of the artery from the heart to the lungs (the pulmonary artery). An abnormal heart sound during a heartbeat (heart murmur) can often be heard during a chest exam. If SVAS is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and ultimately heart failure.\n\nThe severity of SVAS varies considerably, even among family members. Some affected individuals die in infancy, while others never experience symptoms of the disorder.
Pulmonary artery stenosis
MedGen UID:
65965
Concept ID:
C0238397
Anatomical Abnormality
An abnormal narrowing or constriction of the pulmonary artery, in the main pulmonary artery and/or in the left or right pulmonary artery branches.
Pulmonic stenosis
MedGen UID:
408291
Concept ID:
C1956257
Disease or Syndrome
A narrowing of the right ventricular outflow tract that can occur at the pulmonary valve (valvular stenosis), below the pulmonary valve (infundibular stenosis), or above the pulmonary valve (supravalvar stenosis).
Peripheral arterial stenosis
MedGen UID:
870815
Concept ID:
C4025272
Disease or Syndrome
Narrowing of peripheral arteries with reduction of blood flow to the limbs. This feature may be quantified as an ankle-brachial index of less than 0.9, and may be manifested clinically as claudication.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSupravalvar aortic stenosis
Follow this link to review classifications for Supravalvar aortic stenosis in Orphanet.

Conditions with this feature

Supravalvar aortic stenosis
MedGen UID:
2001
Concept ID:
C0003499
Disease or Syndrome
Supravalvular aortic stenosis (SVAS) is a heart defect that develops before birth. This defect is a narrowing (stenosis) of the large blood vessel that carries blood from the heart to the rest of the body (the aorta). The condition is described as supravalvular because the section of the aorta that is narrowed is located just above the valve that connects the aorta with the heart (the aortic valve). Some people with SVAS also have defects in other blood vessels, most commonly stenosis of the artery from the heart to the lungs (the pulmonary artery). An abnormal heart sound during a heartbeat (heart murmur) can often be heard during a chest exam. If SVAS is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and ultimately heart failure.\n\nThe severity of SVAS varies considerably, even among family members. Some affected individuals die in infancy, while others never experience symptoms of the disorder.
Williams syndrome
MedGen UID:
59799
Concept ID:
C0175702
Disease or Syndrome
Williams syndrome (WS) is characterized by cardiovascular disease (elastin arteriopathy, peripheral pulmonary stenosis, supravalvar aortic stenosis, hypertension), distinctive facies, connective tissue abnormalities, intellectual disability (usually mild), a specific cognitive profile, unique personality characteristics, growth abnormalities, and endocrine abnormalities (hypercalcemia, hypercalciuria, hypothyroidism, and early puberty). Feeding difficulties often lead to poor weight gain in infancy. Hypotonia and hyperextensible joints can result in delayed attainment of motor milestones.
Cutis laxa, autosomal recessive, type 1A
MedGen UID:
78663
Concept ID:
C0268351
Disease or Syndrome
FBLN5-related cutis laxa is characterized by cutis laxa, early childhood-onset pulmonary emphysema, peripheral pulmonary artery stenosis, and other evidence of a generalized connective disorder such as inguinal hernias and hollow viscus diverticula (e.g., intestine, bladder). Occasionally, supravalvar aortic stenosis is observed. Intrafamilial variability in age of onset is observed. Cardiorespiratory failure from complications of pulmonary emphysema (respiratory or cardiac insufficiency) is the most common cause of death.
Developmental and epileptic encephalopathy, 23
MedGen UID:
862929
Concept ID:
C4014492
Disease or Syndrome
Developmental and epileptic encephalopathy-23 (DEE23) is an autosomal recessive neurologic disorder characterized by the onset of intractable seizures in the first months of life (range, 2-6 months). Affected individuals have severely impaired psychomotor development with poor or absent speech, cortical blindness, and dysmorphic facial features (summary by Perrault et al., 2014).
Noonan syndrome 12
MedGen UID:
1684730
Concept ID:
C5231432
Disease or Syndrome
Noonan syndrome (NS) is characterized by characteristic facies, short stature, congenital heart defect, and developmental delay of variable degree. Other findings can include broad or webbed neck, unusual chest shape with superior pectus carinatum and inferior pectus excavatum, cryptorchidism, varied coagulation defects, lymphatic dysplasias, and ocular abnormalities. Although birth length is usually normal, final adult height approaches the lower limit of normal. Congenital heart disease occurs in 50%-80% of individuals. Pulmonary valve stenosis, often with dysplasia, is the most common heart defect and is found in 20%-50% of individuals. Hypertrophic cardiomyopathy, found in 20%-30% of individuals, may be present at birth or develop in infancy or childhood. Other structural defects include atrial and ventricular septal defects, branch pulmonary artery stenosis, and tetralogy of Fallot. Up to one fourth of affected individuals have mild intellectual disability, and language impairments in general are more common in NS than in the general population.

Professional guidelines

PubMed

Stephens SB, Novy T, Spurzem GN, Jacob B, Beecroft T, Soludczyk E, Kozel BA, Weigand J, Morris SA
J Am Heart Assoc 2024 Apr 16;13(8):e034048. Epub 2024 Apr 9 doi: 10.1161/JAHA.123.034048. PMID: 38591341
Matisoff AJ, Olivieri L, Schwartz JM, Deutsch N
Paediatr Anaesth 2015 Dec;25(12):1207-15. Epub 2015 Oct 12 doi: 10.1111/pan.12775. PMID: 26456018
Lin AE, Basson CT, Goldmuntz E, Magoulas PL, McDermott DA, McDonald-McGinn DM, McPherson E, Morris CA, Noonan J, Nowak C, Pierpont ME, Pyeritz RE, Rope AF, Zackai E, Pober BR
Genet Med 2008 Jul;10(7):469-94. doi: 10.1097/gim.0b013e3181772111. PMID: 18580689Free PMC Article

Recent clinical studies

Etiology

Choi ES, Park CS, Kim DH, Kwon BS, Yun TJ, Kim MJ, Yang DH
Semin Thorac Cardiovasc Surg 2023 Summer;35(2):359-366. Epub 2022 Apr 15 doi: 10.1053/j.semtcvs.2022.03.011. PMID: 35430353
Sinha M, Parashar N, Pandey NN, Kumar S, Ramakrishnan S
J Card Surg 2021 Apr;36(4):1389-1400. Epub 2021 Feb 15 doi: 10.1111/jocs.15415. PMID: 33590497
Staudt GE, Eagle SS
J Cardiothorac Vasc Anesth 2021 Jan;35(1):176-186. Epub 2020 Jan 21 doi: 10.1053/j.jvca.2020.01.022. PMID: 32127269
Collins RT 2nd
Curr Opin Pediatr 2018 Oct;30(5):609-615. doi: 10.1097/MOP.0000000000000664. PMID: 30045083
Mitchell MB, Goldberg SP
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2011;14(1):85-91. doi: 10.1053/j.pcsu.2011.01.013. PMID: 21444053

Diagnosis

Stephens SB, Novy T, Spurzem GN, Jacob B, Beecroft T, Soludczyk E, Kozel BA, Weigand J, Morris SA
J Am Heart Assoc 2024 Apr 16;13(8):e034048. Epub 2024 Apr 9 doi: 10.1161/JAHA.123.034048. PMID: 38591341
Kozel BA, Barak B, Kim CA, Mervis CB, Osborne LR, Porter M, Pober BR
Nat Rev Dis Primers 2021 Jun 17;7(1):42. doi: 10.1038/s41572-021-00276-z. PMID: 34140529Free PMC Article
Parthiban A, Shirali G
Cardiol Young 2016 Dec;26(8):1543-1552. doi: 10.1017/S1047951116001219. PMID: 28148315
Mitchell MB, Goldberg SP
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2011;14(1):85-91. doi: 10.1053/j.pcsu.2011.01.013. PMID: 21444053
Harikrishnan S, Manohar SR, Nair KK, Tharakan J, Titus T, Kumar VK, Bhat A, Sivasankaran S, Bimal F, Krishna Moorthy KM, Kumar RP
Indian Heart J 2003 Jan-Feb;55(1):49-54. PMID: 12760588

Therapy

Staudt GE, Eagle SS
J Cardiothorac Vasc Anesth 2021 Jan;35(1):176-186. Epub 2020 Jan 21 doi: 10.1053/j.jvca.2020.01.022. PMID: 32127269
Matisoff AJ, Olivieri L, Schwartz JM, Deutsch N
Paediatr Anaesth 2015 Dec;25(12):1207-15. Epub 2015 Oct 12 doi: 10.1111/pan.12775. PMID: 26456018
López Marco A, Nawaytou O, Von Oppell UO
Ann Thorac Surg 2013 Jan;95(1):346-8. Epub 2012 Dec 25 doi: 10.1016/j.athoracsur.2012.05.090. PMID: 23272860
Mitchell MB, Goldberg SP
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2011;14(1):85-91. doi: 10.1053/j.pcsu.2011.01.013. PMID: 21444053
Braunstein PW Jr, Sade RM, Crawford FA Jr, Oslizlok PC
Ann Thorac Surg 1990 Nov;50(5):700-7. doi: 10.1016/0003-4975(90)90665-s. PMID: 2241327

Prognosis

Choi ES, Park CS, Kim DH, Kwon BS, Yun TJ, Kim MJ, Yang DH
Semin Thorac Cardiovasc Surg 2023 Summer;35(2):359-366. Epub 2022 Apr 15 doi: 10.1053/j.semtcvs.2022.03.011. PMID: 35430353
Gal DB, Lechich KM, Jensen HK, Millett PC, Bolin E, Daily J, Jack JT, Stephens S, Jensen MO, Collins RT
Am J Cardiol 2022 Feb 1;164:118-122. Epub 2021 Nov 20 doi: 10.1016/j.amjcard.2021.10.030. PMID: 34815057
Roemers R, Kluin J, de Heer F, Arrigoni S, Bökenkamp R, van Melle J, Ebels T, Hazekamp M
World J Pediatr Congenit Heart Surg 2018 Mar;9(2):131-138. doi: 10.1177/2150135117745004. PMID: 29544407Free PMC Article
Mitchell MB, Goldberg SP
Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2011;14(1):85-91. doi: 10.1053/j.pcsu.2011.01.013. PMID: 21444053
Kimball TR
Pediatr Cardiol 2002 May-Jun;23(3):347-57. doi: 10.1007/s00246-001-0198-5. PMID: 11976781

Clinical prediction guides

Stephens SB, Novy T, Spurzem GN, Jacob B, Beecroft T, Soludczyk E, Kozel BA, Weigand J, Morris SA
J Am Heart Assoc 2024 Apr 16;13(8):e034048. Epub 2024 Apr 9 doi: 10.1161/JAHA.123.034048. PMID: 38591341
Gal DB, Lechich KM, Jensen HK, Millett PC, Bolin E, Daily J, Jack JT, Stephens S, Jensen MO, Collins RT
Am J Cardiol 2022 Feb 1;164:118-122. Epub 2021 Nov 20 doi: 10.1016/j.amjcard.2021.10.030. PMID: 34815057
Min S, Kinnear C, D'Alessandro LCA, Bouwmeester J, Yao R, Chiasson D, Keeley F, Mital S
Circ Genom Precis Med 2020 Dec;13(6):e002971. Epub 2020 Sep 22 doi: 10.1161/CIRCGEN.120.002971. PMID: 32960096Free PMC Article
Deo SV, Burkhart HM, Schaff HV, Li Z, Stensrud PE, Olson TM, Connolly HM, Dearani JA
Ann Thorac Surg 2012 Sep;94(3):854-9. Epub 2012 Jun 22 doi: 10.1016/j.athoracsur.2012.04.022. PMID: 22727249
Kim YM, Yoo SJ, Choi JY, Kim SH, Bae EJ, Lee YT
Cardiol Young 1999 Jan;9(1):37-41. doi: 10.1017/s1047951100007356. PMID: 10323536

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